WHAT IS HEAT STRESS?
1. PURPOSE
To prevent heat-related illnesses by providing guidance in the recognition, evaluation, and control of potential heat stress conditions. The goal of this plan is to minimize potential detrimental health effects for [Company Name] and its subcontractors resulting from excessive heat that may result from working outdoors or within indoor environments with elevated temperatures. This document establishes guidelines to assess and minimize employee health risks resulting from heat stress exposure.
2. SCOPE
To provide information and guidance to the workforce to minimize the occurrence and impact of heat stress at [SITE/PROJECT].
3. IMPROVEMENT
Users of the Document who identify inaccuracy or ambiguity can notify the Custodian or his/her delegate and request changes be initiated.
4. REFERENCES
- All applicable local laws and regulations
- Safety Manual English
- Project HSE Plan
- Emergency Preparedness and Response Procedure
5. RESPONSIBILITY
The overall responsibility for the prevention of heat-related illnesses rests with the Project Manager and his Line Supervision. However, the daily monitoring of employees for signs and symptoms of heat-related disorders rests with the first-line supervisors who shall continually monitor the condition of workers under his authority.
5.1. PROJECT MANAGER
Ensures the Heat Stress Prevention Program and associated guidelines are implemented and administered on the project properly and effectively. Ensure that all personnel affected by heat stress receive proper training.
5.2. HSE MANAGER AND HSE PERSONNEL
Provides employee training, program evaluation, and guidance to construction personnel. Ensure availability of approved employee and visitor training programs. Provide support to and ensure assessment processes are being utilized. Perform informal and formal site inspections to check that the requirements of this guideline are being implemented.
5.3. FIRST-LINE SUPERVISORS
First Line Supervisor shall continually monitor the condition of his workers for employees' work-related capabilities and limitations, and it is paramount that they monitor on a regular basis the condition of each employee assigned to them. They will pay attention to the employee's task, environment, and clothing, as well as any engineering and administrative controls and personal protective equipment in use. He will be aware always of the overall heat stress index and what danger category if any his employees are exposed to.
5.4. EMPLOYEES
Attend training on the requirements of the Heat Stress Management Program. Understand and follow the protocols of this heat stress management plan. Complete an Employee Incident Report for any heat related injury or illness. Comply with applicable safety and regulatory requirements. Report hazardous conditions and dangers to their supervisor. Report any job-related injury or illness to the line supervisor and seek treatment promptly. Promptly notify supervisor of any medical condition, or if they are taking over-the counter medications that might put them at special risk for heat related injury.
6. DEFINITIONS AND ABBREVIATIONS
Company: Name Here
Contractor: Name Here
WBGT: Rena Wet Bulb Globe Temperature
ACGIH: American Conference of Governmental Industrial Hygienists
CT: Check Time
TLV: Time Loaded Value
JSA: Job Safety Analysis
TBT: Toolbox Talk
PPE : Personal Protective Equipment
7. IMPLEMENTATION
7.1. OVERVIEW
Heat stress occurs when the heat load on the body exceeds the body's capacity to cool itself. Four environmental factors affect the amount of heat stress suffered by workers:
- Temperature
- Humidity
- Air velocity
- Radiant heat (such as from the sun, a furnace, or operating equipment)
Every person tolerates heat differently. Heat stress is also affected by several personal characteristics, including:
Acclimation State - Is the worker currently acclimated? Heat acclimation may be reduced when an individual is removed from heat exposure for even a few days.General Physical Fitness - For any work level, the upper limits of heat tolerance are reduced for the physically unfit.
Medical History - A history of heat intolerance, non-acclimatability, or incidence of heat stroke may help predict susceptibility to future heat stress conditions.
Obesity - Fat is an excellent insulator. Obese individuals generally have a lower heat tolerance than lean individuals.
Hypertension - Some studies indicate even moderate hypertensive exhibit reduced heat tolerance.
Organic Heart (heart structure) and/or Vascular Disease - These problems may interfere with an individual's ability to shed excess body heat.
Respiratory Disease - Chronic obstructive pulmonary disease may limit heat tolerance as a function of the seriousness of the disease.
Previous Thermal / Chemical Injury - Individuals who have suffered thermal or chemical burns often have skin conditions that interfere with the body's cooling process and adaptation to heat, thus increasing susceptibility to heat stress.
Infection - The body's response to infection can include fever and fatigue.
Dehydration - Since many heat-related conditions are due to dehydration, a pre-existing state of dehydration will obviously increase susceptibility to heat stress.
Diarrhoea - This condition can lead to dehydration and may itself be a symptom of an underlying medical problem.
Age - Heat tolerance may begin to decline in persons over 50 years of age, due to a sluggish sweat gland response.
Nutrition - Individuals who are not maintaining a balanced diet may have a reduced capacity for performing work and exhibit reduced heat tolerance. Poor nutrition may be the result of illness, stress, dieting to achieve weight loss, etc.
Lack of Sleep - Fatigue can reduce the body's ability to respond to heat stress.
Inadequate Mental Capacity - Be sure that all individuals are capable of understanding heat-related hazards and preventive measures.
Inadequate Ability to Communicate - Be sure that all individuals are capable of describing the symptoms of heat-related illnesses to a co-worker or supervisor.
Working Immediately After Eating - Having food in the stomach diverts some blood from the periphery to the body core.
Other External Agents Affecting Heat Tolerance;
Alcohol - The ingestion of alcohol before or during work causes peripheral vasodilatation and Increases heart rate, thereby reducing heat tolerance.
Illegal Drugs - Many of these substances alter behavioural functions, have serious effects on the central nervous and cardiovascular systems, and affect good judgment, all of which could increase the risk for a heat-related disorder to occur.
Prescription and Over-the-Counter Drugs - There are numerous legal drugs that may limit heat tolerance. Before taking any medicines, employees will consult with their physician regarding any potential effect on heat tolerance. Many of the following drugs can affect heat tolerance: diuretics, vasodilators, central nervous system inhibitors, beta blocking agents, antihistamines, muscle relaxants, amphetamines, atropine, and tranquilizers. Other drugs not mentioned here may also affect certain individuals.
The body generates heat as work is performed. The use of PPE can also have a significant impact on a person's heat load. High heat combined with the use of PPE that reduces the ability of the body to cool itself, such as wearing impervious coveralls and respiratory protection, can elevate the probability of heat stress.
7.2. Normal Response to Excess Heat
- Peripheral vasodilatation (reddened skin) - The skin becomes a radiator and the heart rate increases to move blood more rapidly to the skin for cooling.
- Body surface temperature increases slightly.
- Sweating increases to provide evaporative cooling.
- Acclimation occurs over a few weeks.
Initial heat stress symptoms can quickly progress to heat stroke if an individual is not sensitive to the body's early warning signals or actions are not taken to treat the symptoms. Initial heat stress symptoms include the following:
- Pale, cold, clammy skin
- Rapid, weak pulse
- Weakness, headache, or nausea
- Cramps in the abdomen or limbs
- Excessive perspiration
More severe heat stress signs and symptoms that can indicate heat stroke include:
- Flushed, dry, hot skin
- Rapid, strong pulse
- Skin that feels hot to the touch and body temperatures that are well above normal
- Headaches, dizziness, and nausea
- The body's inability to handle excess heat can lead to a number of different disorders. The table identifies several heat-related disorders, from most severe (heat stroke) to least severe (heat rash).
7.3. TYPES OF HEAT RELATED ILLNESSES
The body's inability to handle excess heat can lead to several different disorders. The table identifies several heat-related disorders, from most severe (heat stroke) to least severe (heat rash).
Heat Stroke: Unconsciousness with hot, dry skin and high body temperature
Heat Exhaustion: Headache, nausea with clammy moist skin
Fainting: Collapse (typically no-acclimatized persons)
Heat Cramps: Muscle pain, typically in legs, arms, or abdomen
Heat Rash: Red skin rash and discomfort
Note: Heat stroke is life threatening and must be treated as a medical emergency.
Heat stroke occurs when the body's system of temperature regulation fails suddenly, and the core temperature rises to critical levels. It is caused by a combination of highly variable factors that result in intolerable heat stress and is often difficult to predict. Drug and/or alcohol abuse may increase the risk of heat stroke.
Individuals who recover from true heat stroke may suffer from permanent physical damage including reduced heat tolerance. These individuals will be carefully evaluated by a competent physician before returning to a job with potential heat stress. Special accommodations to control heat stress may be required for these individuals in order for them to work safely.
7.3.1. Heat Exhaustion:
This is caused primarily by a loss of body fluid, with some loss of body salts due to increased sweating. (Diarrhoea and vomiting both also contribute to dehydration.) Heat exhaustion is similar to heat syncope in that strenuous exercise causes peripheral vasodilatation that reduces blood flow to the brain.
Do not dismiss heat exhaustion lightly. It is possible to confuse the symptoms of heat exhaustion with heat stroke-that is a bona fide medical emergency. In addition, fainting can be dangerous if the individual is operating machinery or controlling an operation that will not be left unattended. Moreover, fainting may injure the victim.
7.3.2. Heat Syncope / Collapse (Fainting):
This condition is caused by prolonged standing, particularly in one spot, while under heat stress. Inactivity can result in excessive pooling of the blood in the extremities, thereby depriving the brain of sufficient oxygen. Consequently, the exposed individual loses consciousness (faints). For prevention, workers will become heat acclimated and avoid prolonged standing in hot weather.
7.3.3. Heat Cramps:
Heat cramps commonly result from performing hard physical work in a hot environment. These cramps are attributable to the loss of body fluids and salt that occurs with profuse sweating.
7.3.4. Heat Rash ("Prickly Heat"):
Heat rash is the most common heat-related problem in the work environment. Inadequate personal hygiene is often an underlying cause. Continuous sweating may irritate skin and sweat glands may become obstructed and inflamed. The condition often occurs in areas where the clothing is restrictive. However, inadequate fluid and salt intake can also cause heat cramps in the absence of sweating or hard work.
7.3.5. Heat Fatigue:
A predisposing factor of heat fatigue includes the lack of acclimation.
8. EMPLOYEE PREVENTION, INFORMATION AND TRAINING
Heat stress awareness training will be provided at least once a year (preferably during the spring) to all project personnel. Training for Staff and for workers/labour will be separated. Staff training shall focus on the elements of recognition/monitoring and preventive measures. Training for labour will focus on symptoms, listening to own body, which personal measures can be taken to prevent heat related illnesses etc. Additional training will be started round about high heat season and Ramadan timings where the risks and exposure to Heat Related Injuries are greater. This training will include:
- The hazards of heat stress
- Instruction in the heat stress index and flag color coding system.
- Recognition of predisposing factors, warning signs, and symptoms and the importance of watching for these symptoms in other employees.
- First-aid procedures for, and potential health effects of, heat stroke and other heat disorders and recovery measures or actions to be taken in case of heat related illnesses.
- Employee responsibilities in avoiding heat stress.
- Dangers of the use of drugs, including prescription and over the counter medicines, and alcohol in hot work environments.
- Proper use of engineering and administrative (work practice) controls.
- Proper use of personal protective equipment.
- Measures employees can take to minimize the effects of heat stress (hydration, work pace, helpful nutritional habits, etc.).
- What to do during a Heat Awareness Condition
- Additional precautions to be implemented during high heat season
- Additional precautions to be implemented during Ramadan including restricted working hours and additional measures to be observed during critical activities.
9. WORKPLACE AND TASK EVALUATION
A thorough evaluation of the workplace will be necessary to identify tasks and conditions that present a potential heat stress hazard. This evaluation will include observations, discussions with workers and supervisors, and the review of any reported heat-related disorders.
A pre-job risk analysis (Last Minute Risk Assessment [LMRA] or Job Safety Analysis [JSA]) will consider the potential for heat stress. Where potential heat stress has been identified for a task, it will be communicated to the workers prior to starting the job.
New employees or workers returning from an extended absence may require a period of adjustment to hot work environments.
First aid plans and medical protocols will include treatment of workers overcome with heat exhaustion and heat stroke. In areas where heat stress is possible, a heat stress management program will be developed. It will identify ambient trigger levels for identified control measures.
The pre-task safety meetings (TSTI or TBT) is the primary vehicle for evaluating and communicating heat stress conditions. Information that can help to determine heat stress potential and appropriate control measures includes the following:
9.1. Job Location:
Already in a very hot environment always analyse the specific locations of each task, including proximity to heat producing equipment such as welding/cutting operations, boilers or location where poor ventilation is present.
9.2. Work Duration and Schedule
What is the frequency at which the task must be performed and how much time is required to perform the work? How much time is required for preparation, setup, actual task performance, and any normal breaks? Excessive overtime work, piece work, and machine-paced work are additional factors to consider. Each can cause fatigue and increase heat stress potential.
9.3. Clothing
What workers wear can make a big difference in how much heat they build up. The use of semi-impermeable or impermeable protective clothing and respiratory protection will increase heat load and metabolic rate. However, clothing can shield a person from radiant heat. Cotton clothing generally retains less body heat. Workers will avoid excessive layering of clothing when heat stress is a potential hazard.
9.4. Metabolism
Working muscles produce metabolic heat. Heavy work can create excess body heat that is a major element in heat stress because it can increase body core temperature and affect the brain's thermoregulatory control (thermostat).
9.5. Environmental Conditions
Air temperature, humidity, wind speed, and direct sunlight all affect heat stress potential. If available, compare WBGT values to the ACGIH exposure times guidelines that are based on the level of work activity. This may help to determine appropriate control measures.
9.6. Existing Controls
What existing heat stress controls are being used? Considerable work can be accomplished in very hot environments if appropriate control measures are taken. On the other hand, simply standing in direct sunlight, for example, can cause heat stress if no controls are in place.
10. CONTROL OF HEAT STRESS
As with any hazard, feasible engineering controls will be the primary control measure, followed by administrative (work practice) controls and PPE, in that order.
10.1. General Ventilation
General ventilation can dilute hot air with cooler air (generally brought in from the outside). Large areas or entire buildings identified as high heat areas may require a permanently installed ventilation system to reduce temperature levels. In smaller areas, portable or local exhaust systems may be more effective or practical.
10.2. Local Ventilation
Reduce heat stress by increasing the air flow and velocity with fans and other movers in the work area (as long as the air temperature is less than the person's skin temperature). If the air temperature is higher than about 100° to 104°F, skin warming may offset any advantage gained by evaporative cooling. Because this method does not cool the air, the increased air flow must contact the worker directly to be effective. This control will have little, if any, positive effect on workers wearing vapor barrier clothing.
10.3. Air Treatment / Air Cooling
This control measure differs from ventilation because it cools the air by removing heat (and sometimes humidity). Mechanical refrigeration can be effective in specific areas such as "cool rooms" (used as recovery areas near hot jobs). Portable blowers with a built in air chiller are effective for cooling asbestos abatement (and similar) enclosures. The main advantages of blowers are portability and minimal set up time.
10.4. Radiant Heat Reduction
Reflective heat shields and insulation will reduce radiant heat. With sources of radiation such as heating pipes, it is possible to use both insulation and surface modifications to achieve a substantial reduction in radiant heat. If shields are used, it is important to minimize their influence on the cooling effects of air flow.
10.5. Shade
Shade will reduce radiant solar heat and is a widely recognized control measure. Shading the work area, rest areas, or equipment or enclosures can significantly decrease the heat load.
11. ADMINISTRATIVE AND WORK PRACTICE CONTROLS
11.1. Scheduling
If possible, perform potentially hot jobs when heat stress conditions are at their minimum. Allow latent heat in equipment to dissipate before work begins. Schedule work for the cooler part of the day, and schedule routine maintenance and repair work in hot areas for the cooler seasons of the year.
11.2. Fluid Replacement
Place ample supplies of liquids close to the work area. Preferred drinks are low-sodium, non-carbonated, non-alcoholic, and non-caffeinated. They will be provided at 50° 60°. Because the normal thirst mechanism does not ensure sufficient fluid intake, encourage workers to drink small amounts on a frequent basis, e.g., one 4-ounce to 6-ounce cup every 20 minutes. The taste of commercially available balanced electrolyte replacement drinks may also encourage fluid intake. (These products are perfectly acceptable when diluted 50% in water.) Although some commercial electrolyte replacement drinks contain salt, this is not necessary for acclimated individuals who generally add enough salt in their diets.
Note: Guidelines must be followed as per Water Quality Index (WQI) fluid intake / replacement, once the Heat Index reached 50° or above the work will be stopped.
11.3. Acclimation
- Workers do not get used to exposure to heat. Acclimation means that the human body has improved the ability to cope with exposure to heat. Acclimation results in less cardiovascular demand for a given activity. The worker will sweat more efficiently (increasing evaporative cooling) and may lose less salt, thus will more easily maintain normal body temperature. Acclimation decreases the risk of heat related illnesses and associated unsafe acts.
- Deliberate acclimation involves exposing employees to work in a hot environment for progressively longer periods.
- Acclimatizing any worker who is unaccustomed to high heat conditions:
Day 1: 50% of normal workload - Day 3: 80% of normal workload
Day 2: 60% of normal workload - Day 4: 100% of normal workload
- Trained workers practicing self-assessment of their own condition.
- Workers using the buddy system.
- Declaring a "Heat Awareness Condition" when extremely hot weather is predicted (listen to daily weather reports).
11.4. Work/Rest Cycles
The work/rest cycle is a method of decreasing heat stress. The work rest plan for this action was developed in conjunction with Project Leadership and Construction Managers and in line with Water Quality Index (WQI) Procedure. This plan was designed to provide simple rules that can be easily implemented.
The site HSE officer under the order of Construction Manager to use an effective means of communication to notify workers of the beginning and end of each interval.
And foreman should use the Work/Rest Cycle Log (See Attachment 2) to record the work/rest time.
The WetBulb Globe Temperature (WBGT) Value must be recorded by Site HSE officer base on Heat Index Chart (See Attachment 4) to consider the Cycle, then notify the foreman and Supervisor to follow the plan to implement the Work/Rest Cycle.
11.5. Buddy System
Working in pairs or small teams allows appropriately trained workers to observe each other for signs of heat-related disorders. Employees may also share work activities to reduce metabolic heat production.
11.6. Personal precautions
[Company Name] and Subcontractors’ employees should be aware of and institute precautions when exposed to heat stress include:
- Fluid intake: The water needed to replace body fluids varies among individuals, but generally workers should drink at least a liter of water for each hour of their shift.
- Control use of electrolytes: Take recommendations from site nurse.
- Dress to Increase Reflection and Convection: Wear light-colored, loose-fitting, breathable clothing.
- Reduce Ultraviolet Radiation: Avoid exposure to direct sunlight.
- Stop the Heat Build-up: Take frequent short breaks in cool shade.
- Reduce Metabolic Heat: Eat light meals before work activity.
- Avoid Dehydrating Liquids: Don’t drink caffeine and alcohol or large amounts of sugary drinks.
12. EFFECTIVE PROACTIVE MEASURES
The following are a few recommendations to aid in the prevention of heat related problems.
- Drink enough fluid before going to work. Waiting until the hottest portion of the day to replenish fluids is too late. Avoid caffeine and alcohol the night before and during the day.
- Dress for conditions. Lightweight, loose clothing is best. Avoid layering clothing underneath coveralls.
- Consume well-balanced diet, such as fruits, vegetables, proteins, and starches work best.
- Electrolyte solutions help to maintain energy levels. Avoid taking salt tablets unless directed to do so by your physician.
- Use sunscreen and cover your face and neck from the sun.
- Provide shaded areas for mini-breaks and water stations.
- Make sure drinking water stations are accessible so employees may take frequent breaks.
- Provide specific areas for employees to go to on a schedule basis (Heat Shelters) and cool off when working in full sun areas. This would be considered mandatory breaks (in addition to the short water breaks). This will be done every 1 to 1-½ hours. This break will be 10-20 minutes in length.
IMPORTANT NOTE:
In case of Emergency situation related with Heat Stress; the Recovery Measures will be as bellows;
- Transfer patient to shady area
- Call for medical assistance
- Put patient in lying position, feet slightly raised
- Use fan, cover with cold packs or cold wet towel
- Give more fluids.
13. TYPICAL REQUIREMENTS FOR HEAT STRESS SHELTERS
- Must be constructed in the work area
- Must be well ventilate
- Adequate supply of cold drinking water
- In Informative signs about Management of Heat Stress posted in English & local language
- Sufficient manpower should be accommodated.
- Fans and setting areas will be provided so that employees can sit and cool down.
14. IMPORTANT SITE IMPLEMENTATION RULES:
- Using a Thermo-Scan type instrument, monitor personnel in their work areas to assure that there are not any consistently high core body temperature problems. Pay attention to areas that have restricted air flow such as foundations, excavations, and vessels.
- Monitor work areas for ambient temperatures. Use the heat index chart to determine the apparent temperature.
- MOST IMPORTANTLY, [Company Name] will not let schedule or productivity influence awareness or caution in high heat weather. Applying work pressure from foreman or self-induced work pressure must be avoided.
- Prepare a Warning Poster for Heat Stress. Key Points of the poster are;
- The emphasis of this program is on the prevention of heat stress.
- Prevention requires the full cooperation of workers, supervisors, and management.
- Initial and periodic training for workers will be provided.
- •The pre-task safety meeting or TBT shall be used for communicating task-specific heat stress conditions.
14.1. Flagging System
A scheme using color coded flags will be implemented as per WQI Heat Stress Management Flagging System to indicate the level of heat stress conditions on a given day. [Company Name] will monitor the given heat stress index throughout the day.
[Company Name] will have nominated person in each area advised as to the current index and to change the flags on an ongoing basis. Area HSE Officers shall monitor and communicate with supervising team and workforce. Flags corresponding to the colour codes, will be installed at visible locations to keep personnel informed and updated of the heat stress conditions for the day.
Flagging System should be followed as per given below chart.
( See in attached downloaded file)
15. RELATED FORMS
Appendix A: USER FEEDBACK FORM
Attachment 1: Heat Stress Information
Attachment 2: Work/Rest Cycle Log
Attachment 3: Heat Stress – Pocket Guide
Attachment 4: Heat Index Chart
HEAT STRESS INFORMATION
Information about Heat Stress
When we hear the term “heat stress,” most of us probably think about an elderly person having a heat stroke. However, heat stress is not designated by age. Even an infant can suffer from a heat illness. Knowing exactly what heat stress is, the different types and prevention methods can mean the difference between life and death.
What is heat stress?
Heat Stress is an illness that occurs as high temperatures and humidity “stress” the body’s ability to cool itself.
What are the different types of heat stress?
Heat Cramps
- Heat cramps are muscle spasms that typically affect your legs, arms and stomach.
- They usually do not take place until later that night when you are relaxing.
- They occur due to heavy sweating and replacing the water but not the salt or potassium.
- Drink electrolyte solutions (Gatorade, PowerAde, etc.) and eat more fruits during the day to prevent heat cramps.
Heat exhaustion
- Heat exhaustion is when the body’s internal air-conditioning system is overworked but has not completely stopped working.
- The blood vessels and capillaries collapse from loss of body fluids and necessary minerals.
- Symptoms include headache, heavy sweating, intense thirst, dizziness, fatigue, loss of coordination, nausea, impaired judgement, and loss of appetite, hyperventilation, tingling in hands or feet, anxiety, cool moist skin, weak and rapid pulse and low to normal blood pressure.
- If someone is suffering from heat exhaustion, they will be moved to a cool place – shaded area or air-conditioned building. They will rest flat on their back with their feet slightly elevated. Their clothing will be loosened, and cool, wet cloths will be placed on their body. Give them electrolyte drinks and water to help cool them down. Make sure to have them checked by medical personnel. They will continue to replace lost body fluids.
Heat stroke
- Heat stroke is life threatening and has a high mortality rate. Doctor will be called as soon as heat stroke is suspected.
- This occurs when the body’s supply of water and salt is depleted, and the body temperature rises to a deadly level.
- Heat stroke is often mistaken for a heart attack.
- You do not always have heat cramps or heat exhaustion prior to having a heat stroke.
- The early symptoms are a temperature of 103 F or greater, a distinct absence of sweating, hot, red or flushed, dry skin, rapid pulse, difficulty breathing, constricted pupils, any or all of the symptoms of heat exhaustion but more severe, bizarre behaviour and high blood pressure.
- More advanced symptoms are seizure or convulsion, collapse, loss of consciousness and a body temperature of over 108 F.
- It is urgent that the victim’s body temperature be lowered. Pour water over them, fan them and apply cold packs.
What can be done to prevent heat illness?
- Get plenty of sleep at night.
- Take advantage of fans and air conditioners.
- Dress in light coloured and lightweight clothing.
- Take breaks if you feel overheated or start to get a headache. Cool off before you begin work again.
- Drink lots of liquids. Electrolyte drinks are best for replacing water and minerals. DO NOT DRINK CAFFEINATED DRINKS (coffee or soda) OR ALCHOLIC BEVERAGES!
- Start slowly and build up to more physical work in order to condition yourself for the hot environment.
- With a little common sense and a few simple precautions,
- Each of us can prevent heat illness.
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